Ticket for Outdoor Patient
| Ward No. 1 | U-PHC No. | Registration No. 02083 | Date 22/11/2018 |
| Token No | SM/19-20/14876 07/12/2019 | Serial | 043 Last Visit: 07/12/2019 |
| Patient Name | Mrs. ANWARA BIBI | Contact No | 9748331516 |
| Address | 50/A CHATRA MUSALMAN PARA ROAD SERAMPORE | Age | 35 YRS Female |
| Token For | Pathology Test | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm BMI: nan |
| Diagnosis | |||